Aim: To determine the validity of the diagnosis of chronic obstructive pulmonary disease (COPD) in general practice in patients given a diagnosis of COPD and treated with bronchodilators. Methods: From the medical records of eight Health Centres in Northern Greece, 319 subjects aged over 40 years and diagnosed as "COPD" were entered into the study. All filled in a special questionnaire and were subjected to spirometry, rhinomanometry and chest X-ray. Results: One hundred and sixty patients

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... %) met the GOLD criteria for COPD. Twenty-six of them were non-smokers and underwent further evaluation: blood eosinophil count, serum IgE assay, high resolution computed tomography (HRCT) scan of the chest, and echocardiography; 16 were given a different diagnosis. One hundred and fifty-nine subjects (49.8%) with an FEV 1/ FVC ratio >0.7 did not meet the GOLD criteria for COPD; 71 suffered from nasal obstruction, 13 from asthma, six had restrictive pulmonary disease and 69 had no respiratory disease. Conclusion: Diagnostic errors in patients with respiratory symptoms in the primary healthcare setting are frequent. Patients suspected to have COPD should undergo spirometry testing after bronchodilation. An alternative diagnosis must be sought for non-smoking patients with irreversible airway obstruction. C o p y r i g h t G e n e r a l P r a c t i c e A i r w a y s G r o u p R e p r o d u c t i o n P r o h i b i t e d The validity of the diagnosis of chronic obstructive pulmonary disease in general practice PA chest X-ray All patients underwent X-ray tests in the radiology laboratories of the Health Centres. Further investigation Patients who showed post-bronchodilator reversibility greater than or equal to 15%, and all those who had an FEV 1 /FVC ratio >0.7 and reported a history of Copyright GPIAG -Reproduction prohibited http://www.thepcrj.org C o p y r i g h t G e n e r a l P r a c t i c e A i r w a y s G r o u p R e p r o d u c t i o n P r o h i b i t e d L. Sichletidis et al. Copyright GPIAG -Reproduction prohibited http://www.thepcrj.org C o p y r i g h t G e n e r a l P r a c t i c e A i r w a y s G r o u p R e p r o d u c t i o n P r o h i b i t e d The validity of the diagnosis of chronic obstructive pulmonary disease in general practice 87 Copyright GPIAG -Reproduction prohibited http://www.thepcrj.org C o p y r i g h t G e n e r a l P r a c t i c e A i r w a y s G r o u p R e p r o d u c t i o n P r o h i b i t e d